Hysterosalpingography is a diagnostic radiological procedure primarily to investigate female infertility. In this procedure, we use fluoroscopic screening of the uterus and the fallopian tubes as we introduce a radio-opaque contrast medium.

This procedure is performed after the period but before ovulation probably between days 1 and 14.

Indications

  • If the female is infertile or there is any kind of history of recurrent miscarriage 
  • If any kind of pain is noticed in the pelvic region.
  • Congenital or acquired uterine anomalies which include septic.
  • If there is any kind of irregularities in menstrual cycles, that includes polyps, fibroids, and adenomyosis.

Contraindications

  • The primary contraindication is pregnancy, for that reason the woman is asked to report on the second or third day after her period’s end. 
  • Patient with active pelvic infection is at a high-risk factor for infection following this procedure and is therefore considered a contraindication.
  • This procedure is not advised during the menstrual period or immediately after it, due to the increased risk of intravasation of contrast with open uterine vessels.
  • Hypersensitivity to contrast agents is also a contraindication to its use in this procedure.
  • Active bleeding from the vagina or if there is suspected malignancy is also considered a contraindication.

Preparation for HSG

 The doctor may advise taking Antibiotic and pain medication an hour before HSG

Procedure 

 The gynecologist will perform the test Patient start by lying down on a table under an X-ray imager called a fluoroscope.  A speculum is inserted into the vagina to keep it open and then cleans the cervix.

A thin tube known as a cannula is inserted inside the cervix and the speculum is removed. The uterus is then filled with a liquid containing iodine as a contrast media. 

Finally, images will be taken with the fluoroscope X-ray. The contrasting liquid will show the outline of your uterus and fallopian tubes and the movement of fluid.

 The doctor may ask patients to move around so they can get side views. When the imaging is completed cannula is removed. 

Vaginal spotting is noticed for a few days after the procedure. Cramps, dizziness, and stomach discomfort are also possible.

What Are the Risks?

  • Patients may have allergic reactions due to contrast media. 
  • Pelvic infection or injury to the uterus is also possible. 
  • Vaginal discharge that smells unpleasant
  • Fainting
  • Severe pain or cramping in the abdomen
  • Vomiting
  • Heavy vaginal bleeding